Why the time is Right for Public-Private Collaboration for State-Level EDW and Analytics Infrastructure?

Gregory Franklin is CEO and Principal at Franklin Health Solutions, a consulting and strategic services company focused on health and Health Information Technology. As a guest HITC contributor, below Gregory discusses public – private collaboration to support the establishment of state-level healthcare data warehouses (Healthcare Decision Support Systems) and their analytical infrastructure.

In 2014, U.S. spending on healthcare is expected to reach nearly 3.1 trillion. And while most of the country’s attention is currently focused on implementing the massive redesign of our healthcare ecosystem, known as the Affordable Care Act (ACA), we can’t afford to ignore the concurrent growth of promising opportunities stemming from the evolution of data management, collection, and analytics. These opportunities are particularly compelling in light of the increased importance of enterprise Healthcare Decision Support Systems (HDSS) and their analytical tools. Today, in this atmosphere of healthcare change and innovation, the nation is in the perfect position to take advantage of the strengths of public-private collaborations to leverage the inherent authority of the public sector, maximize the efficiency and innovation of the private sector, and create high quality, state-level HDSSs with 21st Century analytical tools.

Why Public-Private Collaboration Now?

As a nation, we are in the midst of the largest socio-economic transformation since the creation of Medicare in 1965. The ACA creates a new continuum of coverage, beginning with Medicaid and progressing to unsubsidized health plan coverage sold through the Health Exchange Marketplaces. The ACA also enacts structural reforms of insurance and our current healthcare system that, among other things, assigns payers and providers significantly more risk. However, there are also new opportunities created for the various healthcare delivery systems, public health agencies, communi­ty-based organizations, and other entities involved in the business of healthcare. To take advantage of these opportunities, particularly those that improve health outcomes and better manage cost; meaningful public-private collaboration need to occur.

Because of the enormous scope of the ACA, the transformation of the healthcare system will require sustained, evidence-based decision making that is fueled by the most accurate financial and population health data available from public sources and private initiatives. In order to realize the full advantages of the benefits of the ACA, while avoiding unintended consequences detrimental to both public and private sector missions, there must be a significant investment in focused collaboration. This collaboration is essential to create an environment in which the critical need for good data and analytics can be met through a state-level HDSS equipped with the most modern analytical tools. This robust HDSS would provide the superior business intelligence needed to fashion a new healthcare landscape that promotes an improved patient experience, healthy populations, and reduced healthcare costs. Add to this combination a supply of modernized, analytical tools that contextualize and visualize trends and information; and the landscape for evidence-based decision making is in place.

The Return on Investment

Today, there are over 250 million Americans with health coverage. The ACA can increase that number by another 30 million. States, as well as private entities, will need to categorize and gain an immediate understanding of data reflecting health outcomes, costs and trends, so that smart decisions can be made that further their established goals. The systematic management of healthcare costs and utilization through a HDSS and its applied analytics can save tens of millions of dollars and avoid unnecessary health outcomes that contribute to the current unsustainable overuse of health resources. The benefits of such a HDSS not only provide state entities with what they need to meet their commitment to the public, but also positions private entities with new opportunities to attain their business goals.

There are a variety of potential issues surrounding the development of a state-level HDSS that will obviously need to be addressed prior to any collaboration. For instance, there is no easy answer to solve the differences that public entities and private firms face in terms of rules, policy restrictions, laws, and goals. Additionally, there are few industries as complex as healthcare. But, there’s no doubt the transformation of our healthcare system will inevitably lead to changes in the nature of the historical relationships between public and private entities. However, public-private collaboration is not insurmountable. Once the issues are addressed, we all will reap the benefits. The time and opportunity to engage in collaboration and establish HDSSs with stronger analytics is now!

The article lays the foundation for further contributions on this topic, Healthcare IT Connect is interested to hear from both public and private stakeholders regarding innovative models to establish state-level EDW and analytics infrastructure and associated healthcare transformation efforts, please email victorias@healthcareitconnect.com if you would like to contribute to this discussion and present additional use cases and data on the topic. Please view the agenda for the 2014 State Healthcare IT Connect Summit, April 1-2 to view topics aligned to this discussion around data governance, analytics and population health management, Greg Franklin is one of the confirmed speakers at the meeting.